As a result of 9/11, hospitals redesigned departments and protocols to better respond to terrorist events.²Now, future hospitals will likely be designed to better respond to pandemic events.

In a pandemic, experts agree that built-in flexibility is needed in the structure and layout of hospitals.³随着199名患者的增加，设施竭尽所能。现在，组织正在寻找更具战略性行动的方法。这可能包括将床计数扩展到标准模型之外的方法，或者如何通过单独的空气过滤系统隔离医院的不同区域。而且，虽然医院通常不会比平均患者数量更多的供应量，但他们现在开始保留更多的供应量。

组织可能会开始评估其当前蓝图，并注视着每个单元中的床位，存储，个人防护设备（PPE）的量，机械呼吸机的数量以及每个临时或永久性前房的位置。检查医疗空间和识别缺陷的最有用的方法之一是使用原位模拟– which is a form of team-based simulations run in the real clinical environment.除了测试房间的逻辑流外，原位模拟还被证明可以提高团队合作，沟通技巧和患者安全成果.⁴

As one of the few interventions shown to benefit patients with COVID-19 is mechanical ventilation, there has been an increased focus on the skills required to manage a ventilator. Typically, these skills are exclusive to the respiratory therapist or intensivist and, at almost 50% of hospitals, there is not an intensivist who regularly performs rounds.⁵

In addition to the skills required to manage the ventilator itself, hospitals discovered that they did not have a sufficient number of personnel authorized to intubate and extubate their patients. Without adequate staff permitted to intubate patients prior to putting them on a ventilator, unnecessary delays were identified. And, the high risk for aerosolization of respiratory secretions during extubation required additional precautions to be put in place.

尽管对急性呼吸窘迫综合征（ARDS）的大规模培训可能不是其原始培训议程的一部分，但医院必须迅速调整其计划，以确保跨学科的提供者有信心治疗Covid-19患者。This ability to quickly and seamlessly change course was an important determinant for how well a hospital responded to the pandemic.

仿真培训有助于增强临床理解，并为提供者在对待真正的患者之前提供动手实践的机会。当医院正在努力培训一大批从业人员执行一项特定任务时，模拟可以使该培训对参与者产生影响。而且，在短时间进行此培训时，使用预编程的模拟场景可以节省时间。

Nationally, Blacks, Hispanics and other minority populations are disproportionally affected by COVID-19.⁶And, unfortunately,冠状病毒只会加剧现有和著名的健康差异.

与白人患者相比，种族和少数民族的成员不太可能接受预防性卫生服务，并且经常获得较低质量的护理。⁷这与社会经济和人口统计学因素结合，导致了少数民族的灾难性医疗保健结果。提供者不仅必须适应这些因素，而且还必须训练以不断发展其文化能力。使用模拟来训练多样化的患者人群 - 特别是使用肤色较深的模拟器可以为从业者创造大开眼界的学习体验。

While COVID-19 has brought greater awareness to health disparities among racial and ethnic minorities, it has also encouraged healthcare providers to strengthen their interpersonal and communication skills with全部患者和彼此。来自不同学科的护理提供者以前所未有的方式汇集在一起​​，并有望作为一支高度功能的团队表演。

在正常情况下，患者家庭在脆弱的患者病例中尽可能地参与其中。Covid-19破坏了这一点，因为医院不允许床边的家人或访客。这意味着关键的患者和死亡附近的患者一直仅依靠医疗保健提供者来获得情感支持，并且提供者需要表现出最强的人际交往能力。

基于跨学科的团队模拟培训通常以一种可以提高临床准确性的学习方法而闻名。但是，这种培训通常还可以帮助学习者改善他们的方式与患者互动on a personal level. Communication skills, rapport building, emotional support, and increased patient trust are all vital to positive patient outcomes and patient satisfaction. And, this type of training provides an opportunity for healthcare providers to practice the use of a Crew Resource Management (CRM) or TeamSTEPPS tool for improved team communications with each other, too.